{
  "abstract": "Introduction Hospital attendances due to respiratory infection peak in winter, contributing to pressures within acute services. We assessed the prevalence of suspected respiratory infection within acute medical admissions during winter and evaluated performance against recommendations for initial assessment.Methods Data were collected through the Society for Acute Medicine (SAM) Benchmarking Audit, comprising a hospital-level survey and 24-hour patient-level data collection for unplanned acute medical attendances on 22 February 2024. Performance metrics assessed included those from the SAM’s clinical quality indicators (CQI) for medical admissions, and British Thoracic Society (BTS) guidelines for community acquired pneumonia.Results Data were available for 4390 patients at 76 hospitals. Suspected respiratory infections accounted for 22.8% of all unplanned medical attendances; these patients were older (age ≥70 years: 58.2% vs 44.7%, p<0.001) and had higher National Early Warning Score 2 (NEWS2) scores (NEWS2 ≥3: 63.8% vs 23.8%, p<0.001) than those without respiratory infection; they were more likely to be assessed in the emergency department (80.8% vs 63.7%, p<0.001), and had lower rates of discharge without overnight admission (14.9% vs 35.9%, p<0.001). 71.0% of patients underwent a chest X-ray within 4 hours of arrival; 27.0% were reported within 12 hours. Antibiotics were administered ≥4 hours from arrival in 32.9%. Performance against these indicators varied between hospitals. Nine hospitals (12.7%) had a separate respiratory admission service; this was not associated with improved performance against SAM CQIs or BTS guidance.Conclusion Respiratory infections contribute significantly to acute medical attendances via the emergency department. There remains significant scope to improve key steps in initial assessment and management.",
  "authors": [
    {
      "affiliations": [
        "Inflammation and Ageing, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK",
        "Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "Catherine Atkin"
    },
    {
      "affiliations": [
        "Department of Clinical and Biomedical Sciences, University of Greater Manchester, Bolton, UK"
      ],
      "name": "Mark Holland"
    },
    {
      "affiliations": [
        "Acute Medicine, Manchester University NHS Foundation Trust, Manchester, UK",
        "The Christie NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Tim Cooksley"
    },
    {
      "affiliations": [
        "Acute Medicine, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK"
      ],
      "name": "Ragit Varia"
    },
    {
      "affiliations": [
        "Ysbyty Gwynedd, Bangor, UK",
        "School of Medical Sciences, Bangor University, Bangor, UK"
      ],
      "name": "Christian P Subbe"
    },
    {
      "affiliations": [
        "Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK"
      ],
      "name": "Tom Wilkinson"
    },
    {
      "affiliations": [
        "Warwick Medical School, University of Warwick, Coventry, UK",
        "Department of Geriatric Medicine, John Radcliffe Hospital, Oxford, UK"
      ],
      "name": "Daniel Lasserson"
    },
    {
      "affiliations": [
        "Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK",
        "NIHR Midlands Patient Safety Research Collaboration, University of Birmingham, Birmingham, UK",
        "NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK",
        "School of Medical Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Elizabeth Sapey"
    }
  ],
  "title": "Performance against quality indicators in the initial assessment of patients with respiratory infections in acute medicine services",
  "uid": "722e711a-859e-59de-bcfe-d33fd75fbe0b"
}